经皮肾镜治疗输尿管上段结石并重度肾积水26例分析  

Treatment of calculus of the upper segment of ureter with severe hydronephrosis by PCN

作　　者：胡少群[1] 曹国灿[1] 吴志坚[1] 陈弟荣[1] 李晓刚[1] 付发军[1] 曹阳[1] 刘继红[2] 

机构地区：[1]湖南省郴州市第一人民医院泌尿外科,湖南郴州423000 [2]华中科技大学同济医学院附属同济医院泌尿外科

出　　处：《临床泌尿外科杂志》2005年第2期75-76,共2页Journal of Clinical Urology

摘　　要：　　　目的:探讨输尿管上段结石并重度肾积水的经皮肾治疗方法。方法:经皮肾镜治疗输尿管上段结石并重度肾积水26例。10例直接经皮肾穿刺建立通道行经皮肾镜手术(顺行法)。16例先逆行置输尿管镜达输尿管上段,将输尿管导管绕过结石插入肾盂,再经皮肾穿刺建立通道行经皮肾镜手术(逆行法)。结果:逆行法组均成功找到肾盂输尿管连接部,平均手术时间(2.05±0.12) h;顺行法组平均手术时间为(2.81±0.23) h,2 例因术中未找到肾盂输尿管连接部而行改行体外冲击波碎石治疗。结论:逆行法是经皮肾镜治疗输尿管上段结石并重度肾积水较好的方法,特别是适合于初学者。Objective:To explore the ideal treatment for calculus of the upper segment of ureter with severe hydronephrosis by PCN.Methods:From January, 2003 through March, 2004, 26 cases of calculus of the upper part of ureter with severe hydronephrosis were treated by PCN. The renal tract of percutaneous nephrolithotomy were established directly (antegrade way) in 10 cases. The other 16 cases first received retrograde ureteral catheter and then the renal tract for percutaneous nephrolithotomy were established(retrograde way).Results:All cases receiving 'retrograde way' PCN were operated on successfully, the mean operating time was ( 2.05± 0.12) hours. For the 10 cases receiving 'antegrade way' PCN, 8 were successfully operated on and other 2 cases failed in finding the UPJ outlet, the mean operating time was ( 2.81± 0.23) hours.Conclusions:'Retrograde way' is the treatment of choice for patients with calculus of the upper segment of ureter with severe hydronephrosis.

关 键 词：经皮肾镜 肾积水 输尿管结石 

分 类 号：R692.2[医药卫生—泌尿科学]